HomeMy WebLinkAboutNCC215326_NOI Application_20210927Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 9/25/2021 1:21:14 PM (NCG01 NOI Submission)
Approve by Broussard, Brooklyn C 9/27/2021 6:55:16 AM (Review- Construction NOI 66491)
• The task was assigned to Broussard, Brooklyn C by round robin distribution 9/25/2021 1:21 PM
The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: September 29, 2021 5:00
PM 9/25/2021 1:21 PM
Submit by Selkane, Aziza 9/27/2021 10:27:42 AM (Payment Verification for NCC215326)
* Stacey L Tibbs
• Selkane, Aziza assigned the task to Selkane, Aziza 9/27/2021 10:26 AM
The task was assigned to DEMLR NCG01 Payment Team. The due date is: November 8, 2021 5:00
PM 9/27/2021 6:55 AM
.• SThF� ';
1
NORTH CAROLINA
EnrlronmertW quallly
A. Project Information
Part A.
Project Location and Waterbody Information
Are you submitting f• No
an NOI that was r Yes
rejected before?
1a. Project Name * Line 2064 XBrace Replacement
1 b. Specific Lot This field nay be used to list sped lot nunbers.
Numbers 8957-91-5549, 8957-91-9193, 8967-01-0585, 8967-12-1345, 8967-11-2859,
8967-13-2565, 8967-32-2706, 8967-44-2235, 8967-99-3166, 8967-99-3166,
8977-35-7551, 8977-53-5874, 8977-63-5410, 8977-72-0719, 8977-72-9651,
8977-92-5014, 8977-90-9187, 8987-21-8518, 8987-33-0088, 8987-32-1848,
8987-32-2607, 8987-32-4629, 8987-32-4866, 8987-33-3026, 8987-33-5062,
8987-33-8050, 8987-43-0076, 8987-41-9241, 8987-61-4857, 8987-72-0867,
8987-82-3161, 8997-00-1656, 8997-00-6168, 8996-09-8902, 8997-10-6414,
8996-09-3148, 8997-10-4024, 8996-19-4818, 8997-30-8305, 8996-39-3682,
8996-29-2031, 8996-29-9076, 8996-28-1309, 8996-28-6344, 8996-38-1337,
8996-38-7291, 8996-45-4765, 8996-45-5010, 8996-54-3665, 8996-44-3364,
8996-64-2257, 8996-61-4081, 8996-61-7133, 8996-71-4239, 8995-79-3651,
8995-79-1307, 8995-79-2176, 8995-78-0919, 8995-78-3953, 8995-98-4013,
9905-07-0051, 8995-95-4773, 8995-95-0548, 8995-95-1489, 8995-95-
2460,8995-95-1286, 8995-95-4384, 8995-94-4929, 8995-94-5559, 9905-04-0103,
9905-04-4274, 8995-93-8880, 9905-13-2506, 9905-02-3923, 9905-20-5908,
9905-20-8481, 9904-39-0380, 9904-47-1630, 9904-45-2842, 9904-65-1295,
9904-73-8432, 9913-08-0307, 9903-97-0144, 9903-87-2060, 9903-76-7656,
9903-86-2416, 9903-76-9445, 9903-85-2866, 9903-49-8339, 9903-85-7111,
9903-84-9573, 9903-94-1144, 9903-93-2892, 9903-93-0378, 9903-92-0904,
9903-92-1588, 9903-92-8171, 9913-01-2488, 9913-01-4120, 9913-00-6230,
9912-09-7845, 9912-19-0508, 9912-19-5143, 9912-08-8865, 9912-19-0095,
9912-19-9034, 9912-18-1971, 9912-18-5369, 9912-28-2186, 9912-18-5006,
9912-17-6906, 9912-27-3782, 9912-27-6443, 9912-37-3044, 9912-36-4276,
9912-35-4800, 9912-44-0740, 9912-53-2207, 9912-52-1804, 9912-52-2508,
9912-42-5376, 9912-52-4288, 9912-52-7071, 9912-51-6402, 9912-70-0337,
9911-68-8313, 9911-77-1940, 9911-77-0589, 9911-76-6677, 9911-75-9827,
9911-74-4953, 9911-84-3162, 9911-83-8655, 9911-93-1280, 9911-92-1847,
9911-92-1546, 9911-92-3000, 9911-91-6610, 9911-80-9962, 9911-90-1551,
9911-90-2349, 9911-90-3218, 9911-90-3187, 9911-90-6272, 9911-90-7153,
9911-90-8043, 9910-99-9942, 9920-09-0896, 9920-09-1774, 9910-99-0326,
9920-09-2556, 9920-09-1294, 9910-98-6647, 9920-07-0523, 9920-18-0561,
9910-96-8439, 9920-17-3748, 9920-17-4618, 9920-17-4587, 9920-17-5436,
9920-17-6304, 9920-17-6160, 9920-16-9803, 9920-27-1680, 9920-26-1281,
9920-36-3136, 9920-35-6474, 9920-22-5905, 9920-43-5445, 9837-63-9761,
9837-52-7044, 9837-73-2479, 9837-73-1243, 9837-73-2136, 9837-73-5695,
9837-73-3004, 9837-73-4239, 9837-73-5201, 9837-73-5163, 9837-72-3932,
9837-81-2732, 9837-81-8357, 9837-81-6270, 9837-90-8326, 9846-09-3130,
9846-09-3130, 9846-26-7234, 9846-36-5245, 9846-34-3109, 9846-44-1733
1 c. Parcel ID List all RNIs associated w ith this project.
Number(s) (PIN) 8957-91-5549, 8957-91-9193, 8967-01-0585, 8967-12-1345, 8967-11-2859,
8967-13-2565, 8967-32-2706, 8967-44-2235, 8967-99-3166, 8967-99-3166,
8977-35-7551, 8977-53-5874, 8977-63-5410, 8977-72-0719, 8977-72-9651,
8977-92-5014, 8977-90-9187, 8987-21-8518, 8987-33-0088, 8987-32-1848,
8987-32-2607, 8987-32-4629, 8987-32-4866, 8987-33-3026, 8987-33-5062,
8987-33-8050, 8987-43-0076, 8987-41-9241, 8987-61-4857, 8987-72-0867,
8987-82-3161, 8997-00-1656, 8997-00-6168, 8996-09-8902, 8997-10-6414,
8996-09-3148, 8997-10-4024, 8996-19-4818, 8997-30-8305, 8996-39-3682,
8996-29-2031, 8996-29-9076, 8996-28-1309, 8996-28-6344, 8996-38-1337,
8996-38-7291, 8996-45-4765, 8996-45-5010, 8996-54-3665, 8996-44-3364,
8996-64-2257, 8996-61-4081, 8996-61-7133, 8996-71-4239, 8995-79-3651,
8995-79-1307, 8995-79-2176, 8995-78-0919, 8995-78-3953, 8995-98-4013,
9905-07-0051, 8995-95-4773, 8995-95-0548, 8995-95-1489, 8995-95-
2460,8995-95-1286, 8995-95-4384, 8995-94-4929, 8995-94-5559, 9905-04-0103,
9905-04-4274, 8995-93-8880, 9905-13-2506, 9905-02-3923, 9905-20-5908,
9905-20-8481, 9904-39-0380, 9904-47-1630, 9904-45-2842, 9904-65-1295,
9904-73-8432, 9913-08-0307, 9903-97-0144, 9903-87-2060, 9903-76-7656,
9903-86-2416, 9903-76-9445, 9903-85-2866, 9903-49-8339, 9903-85-7111,
9903-84-9573, 9903-94-1144, 9903-93-2892, 9903-93-0378, 9903-92-0904,
9903-92-1588, 9903-92-8171, 9913-01-2488, 9913-01-4120, 9913-00-6230,
9912-09-7845, 9912-19-0508, 9912-19-5143, 9912-08-8865, 9912-19-0095,
9912-19-9034, 9912-18-1971, 9912-18-5369, 9912-28-2186, 9912-18-5006,
9912-17-6906, 9912-27-3782, 9912-27-6443, 9912-37-3044, 9912-36-4276,
9912-35-4800, 9912-44-0740, 9912-53-2207, 9912-52-1804, 9912-52-2508,
9912-42-5376, 9912-52-4288, 9912-52-7071, 9912-51-6402, 9912-70-0337,
9911-68-8313, 9911-77-1940, 9911-77-0589, 9911-76-6677, 9911-75-9827,
9911-74-4953, 9911-84-3162, 9911-83-8655, 9911-93-1280, 9911-92-1847,
9911-92-1546, 9911-92-3000, 9911-91-6610, 9911-80-9962, 9911-90-1551,
9911-90-2349, 9911-90-3218, 9911-90-3187, 9911-90-6272, 9911-90-7153,
9911-90-8043, 9910-99-9942, 9920-09-0896, 9920-09-1774, 9910-99-0326,
9920-09-2556, 9920-09-1294, 9910-98-6647, 9920-07-0523, 9920-18-0561,
9910-96-8439, 9920-17-3748, 9920-17-4618, 9920-17-4587, 9920-17-5436,
9920-17-6304, 9920-17-6160, 9920-16-9803, 9920-27-1680, 9920-26-1281,
9920-36-3136, 9920-35-6474, 9920-22-5905, 9920-43-5445, 9837-63-9761,
9837-52-7044, 9837-73-2479, 9837-73-1243, 9837-73-2136, 9837-73-5695,
9837-73-3004, 9837-73-4239, 9837-73-5201, 9837-73-5163, 9837-72-3932,
9837-81-2732, 9837-81-8357, 9837-81-6270, 9837-90-8326, 9846-09-3130,
9846-09-3130, 9846-26-7234, 9846-36-5245, 9846-34-3109, 9846-44-1733
2. County*
Currituck
3. Highway or Street
Highway 158
Address *
Street narre only is acceptable if no address nun ber assigned yet
4. City or Township*
Various, Shawboro to Point Harbor
5. State *
NC
6. Zip Code*
27973
7. Latitude*
Enter the latitude in decimal degrees
36.3848
8. Longitude*
Enter the longitude in decirral degrees (MJSTbe negative)
-76.0798
If you do not know the latitude
and longitude coordinates for this project, you can search the location on this map of
North Carolina. Look for the coordinates in the bottom left corner.
9. Date to Begin*
10/01/2021
Estimated Construction Project Start Date
10. Date to End*
12/31/2021
Estirrated Construction Project End Date
11. SIC (Primary)*
Other (9999)
Standard Industrial aassification for Ceveloprrent
12. Acres to be
104.49
disturbed*
(including off -site borrow and waste areas)
13. Total site area 333.34
(acres) *
14. Post- 0.00
construction (Estirrated)
impervious area
(acres) *
Project Tracking ID NCC-CURRI-2021-Line 2064 XBrace Replacement
Assigned automatically (not used)
Below you must enter waterbody information for surface waters affected by this project. Please consult
DWR's Surface Water Classifications Map Viewer to find waterbody name and corresponding index number. Please
enter only immediate receiving waterbodies - not waters downstream of those unless the project extends there. You
may enter up to 3 waterbodies if needed.
15a. Receiving East Creek
Waterbody* %rreof waterbody into which storrrwater runoff will discharge
15b. Waterbody 30-2-3
Index No. * NCWaterbody Index Nurrber
Stormwater F No
discharges will flow 17 Yes
to additional
wate rs *
15c. Additional Coinjock Bay
Receiving Waterbody narre
Waterbody
15d. Waterbody 30-1-6
Index No. NCWaterbody Index Nurrber
15e. Additional Intracoastal Waterway
Receiving Waterbody narre
Waterbody
15f. Waterbody NCWaterbody Index Nurrber
Index No.
16a. Is this project F Yes
subject to the NC r No, not subject to NC SPCA
Sediment Pollution
Control Act?*
B. Permittee Information
Part B.
F2rnittee Inforrration - Legally Fbsponsible Entity and Individual
.........................................................................................................................................................
Important: The person who signs the NOI Certification Form and signs the Certification in Section E of this application
form must be the same person as listed in THIS SECTION, or an authorized responsible individual within the same
organization. That person must be a responsible corporate officer who owns or operates the construction activity, such
as a president, secretary, treasurer, or vice president, or a manager that is authorized in accordance with Part IV,
Section B, Item (6) of the NCG010000 General Permit. For more information on signatory requirements, see Part
IV, Section B, Item (6) of that permit.
1. Permittee * Legally Pesponsible Entity
Virginia Electric and Power Company d/b/a Dominion Energy North
Carolina
It pernittee is an individual, enter first and last narre in this field. Ctherwise, enter organization/business narre.
Note: If the permittee is a business, the business must be registered with the NC Secretary of State. You can verify the
registration here.
2. First Name* Mark
If Corporation, enter Faegistered Agent First Wre
3. Last Name* Allen
It Corporation, enter Registered Agent Last %r e
3b. Title Director, Electric Transmission Project Development and Execution
4. Permitee E-mail mark.allen@dominionenergy.com
Address*
5. Permittee (804) 257-4711
Telephone No.*
6. Permittee Mailing Street Address
Address* 10900 Nuckols Road
Address Line 2
4th Floor
Cty
Glen Allen
Fbstal / Zip Code
23060-9276
Check box if the
street address the
same as mailing
address
7. Permittee Street
Address *
V Yes
Street Address
10900 Nuckols Road
Address Line 2
4th Floor
city
Glen Allen
Postal / Zip Code
23060-9276
State / Rovince / Region
VA
Country
us
State / Province / Region
VA
Country
us
8. Type of ON nership is only individual if an individual is narred in B.1. above.
Ownership* Non -Government
C. Site Contact Information
Part C.
^
Roject Site Contact Inforrration
.......................................................................................................................................................................................................................................................................................................................................................................................
1. Primary Site
Eric
Contact - First
Name *
2. Primary Site
Clay
Contact - Last
Name *
3. Title
Construction Consultant
4. Site Contact E-
james.e.clay@dominionenergy.com
mail Address*
5. Site Contact
(804) 335-9534
Telephone No.*
6. Organization
Virginia Electric and Power Company d/b/a
Name
Dominion Energy North Carolina
7. Site Contact
Street Address
Mailing Address*
10900 Nuckols Road
Address Line 2
4th Floor
city
State / Rovince / Region
Glen Allen
VA
Flostal / Zip Code
Country
23060-9276
us
8. Consultant Name
(Optional)
Monica Young
First and Last narre
9. Consultant E-mail
monica.e.young@dominionenergy.com
This person will be copied on all correspondence.
10. Consultant
(910) 232-7505
Telephone No.
11. Billing E-mail
(For Annual Fee correspondence)
et.environmental@dominionenergy.com
Default is legally responsible person a-rrail
12. Billing
(For Annual Fee correspondence)
Telephone
(910) 232-7505
Default is legally responsible person telephone
D. E&SC Plan
Part D. ^
Erosion & Sediment Control (E&SC) Ran Approval Information
......................................................................................................................................................................................................................................................................................................................................
1. Date E&SC Plan 09/21/2021
Approved *
2. E&SC Plan Project Curri-2022-004
Number/ID * Assigned by agency or local program
3. E&SC Plan r State DEQ Office
Approved by* r Local Program
4. State DEQ Office * Washington (WaRO)
Documentation of E&SC Plan approval and the signed Notice of Intent (NOI) Certification Form is required for a
complete application. Please also upload a site map showing the overall extent of the project (for linear projects, can
include the beginning point and end point coordinates in the "Notes" box below).
5. E&SC Plan Curri-2022-004 Line 2064 X Brace Replacement
Approval letter or 1.44MB
LOA - 09212021.pdf
Grading Permit
Mast be RDFfon-rat
6. Signed FRO Financial Pesponsibility/Ojvnership Form
Line 2064 XBrace - FRO Form_signed.pdf 162.93KB
Mast be RDFfornat
7. Site Location Map Mast be RDFforrrat (lirrit 20IVB)
Line 2064 XBrace - Location Map.pdf 374.53KB
Rease do not upload entire set of E&SC plans.
8. Notes (Optional) Frovide any additional information that night help the reviewer better understand how uploaded documents support
the application. Include additional w aterbodies if necessary.
9. NOI Certification Line 2064 XBrace - eNOI Certification Page.PDF 1.47MB
Form Mast be RDFfon-rat
This is an Express r No
Review Project* r Yes
E. Certification
North Carolina General Statute 143-215.66 (1) provides that:
Any person who knowingly makes anyfalse statement, representation, or certification in any application, record, report, plan, or other
document filed or required to be maintained under this Article or a rule implementing this Article; or who knowingly makes a false statement
of a material fact in a rulemaking proceeding or contested case under this Artcle; or who falsifies, tampers with, or knowingly renders
inaccurate any recording or monitoring device or method required to be operated or maintained under this Article or rules of the
Commission implementing this Artcle shall be guilty ofa Class 2 misdemeanor which may include a fine not to exceed ten thousand
dollars ($10,000).
Under penalty of law, I certify that:
17 I am the person responsible for the construction activities of this project, for
satisfying the requirements of this permit, and for any civil or criminal penalties
incurred due to violations of this permit.
rJ The information submitted in this NOI is, to the best of my knowledge and belief,
true, accurate, and complete based on my inquiry of the person or persons who
manage the system, or those persons directly responsible for gathering the
information.
* 17 I will abide by all conditions of the NCG010000 General Permit and the
approved Erosion and Sediment Control Plan.
* rJ I hereby request coverage under the NCG010000 General Permit and
understand that coverage under this permit will constitute the permit
requirements for the discharge(s) and is enforceable in the same manner as an
individual permit.
Specify if you are:* IT The Legally Responsible Person named on this Notice of Intent
f Authorized Responsible Person* (signing on behalf of Legally Responsible
Person named in Part B)
Important: The person who electronically signs this Certification above must be the same person who signs the NOI
Certification Form. If that person is signing on behalf of the Permittee, that individual must be an authorized responsible
person within the same organization as the Permittee. *An authorized individual is a responsible corporate officer who
owns or operates the construction activity, such as a president, secretary, treasurer, or vice president, or a manager
that is authorized in accordance with Part IV, Section B, Item (6) of the NCG010000 General Permit. For more
information on signatory requirements, see Part IV, Section B, Item (6) of that permit.
Signature
60"7 tf
Type Name * Mark Allen
Title Director, Electric Transmission Project Development and Execution
Organization Legally Plesponsible Entity
Virginia Electric and Power Company d/b/a Dominion Energy North
Carolina
Date * 09/25/2021
F. Tracking and COC Info
NOI Tracking No. 66491
NC Reference No.
NCG01-2021-5326
Uses 'count_nurrber' variable (increrrented by SP)
Certificate of
NCC215326
Coverage (COC)
Uses 'count_nurrber' variable (increrrented by SP)
No.*
Count Number 5326
Sequential nurrber for subrrittal that is incremented by Stored Frocedure
COC Year 2021
Year of date reviewed (used to assign YY digits after "NOC' in COCno.)
Initial Invoice No. NCC215326-2021
Invoice Due Date 10/27/2021
Initial Fee $ 100.00
Invoice Status OPEN